Planet of the apex

Surv Ophthalmol. 2024 May-Jun;69(3):495-498. doi: 10.1016/j.survophthal.2023.11.007. Epub 2023 Nov 23.

Abstract

A 63-year-old man with diabetes presented with unilateral ptosis and an exotropia. A diagnosis of isolated diabetic III nerve palsy was made. Subsequent neuro-ophthalmologic evaluation showed multiple cranial nerves involvement consistent with a diagnosis of orbital apex syndrome. Review of past medical history was significant for a previous nasopharyngeal carcinoma, and biopsy of the involved site was consistent with tumor recurrence. This case highlights the importance of correct medical history taking and anatomo-clinical correlation in neuro-ophthalmology.

Keywords: Diabetic palsy; Diplopia; Nasopharyngeal carcinoma; Orbital apex syndrome.

Publication types

  • Case Reports

MeSH terms

  • Blepharoptosis* / diagnosis
  • Blepharoptosis* / etiology
  • Carcinoma / diagnosis
  • Exotropia / diagnosis
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma / diagnosis
  • Nasopharyngeal Carcinoma / pathology
  • Nasopharyngeal Neoplasms / complications
  • Nasopharyngeal Neoplasms / diagnosis
  • Oculomotor Nerve Diseases / diagnosis
  • Tomography, X-Ray Computed